Should I do chin liposuction, Botox, or something else to help with my chin ptosis? (Photos)

Question

I’ve always hated how my chin juts out forward and doesn’t blend in with the rest of my face. It‘s uneven from the front so it throws the rest of my face symmetry off. I also don’t like how my side profile is different on each side when I smile. I was considering chin Botox but I’d rather spend more for more permanent results. I was wondering if there are any other procedures to look into before going in for a consultation. I feel the ptosis is getting worse with age and so I’d like to look into different avenues asap. I am female, 5’4, 130lbs, and 22 years old. Thank you!

Lucian Ion, FRCS · Answer

Thank you for your question and for sharing your photographs.

The appearance you are describing is due to a dynamic repositioning of the chin mound related to the contraction of the mentalis muscle. When this muscle contracts, it can cause the chin to project forward or appear uneven, particularly when smiling or moving the lower face.

Because of this, static interventions such as chin liposuction would not address the underlying cause of the concern. Liposuction is designed to remove fatty tissue and is therefore unlikely to improve changes in chin position that occur as a result of muscle activity.

For this reason, Botox remains a more predictable solution. By reducing the activity of the mentalis muscle, Botox can improve the movement and contour of the chin. The treatment can also be carefully titrated over a few sessions to achieve the most appropriate effect.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your concerns and photos—this helps a lot in understanding what’s happening. From what you’re describing and showing, a few things stand out: the chin projection, asymmetry when smiling, and the sense of “ptosis” or sagging that you’ve noticed over time.

Chin ptosis or a downward sag can have several contributing factors: skin laxity, underlying muscle activity, or even the natural shape of the bone and soft tissue. Here’s a breakdown of potential approaches:

Chin Botox (mentalis relaxer):

This can soften dimpling and reduce a “pouty” or overly active chin, but it’s temporary (3–6 months).

It won’t significantly change projection or correct asymmetry from bone structure.

Chin liposuction / submental liposuction:

Primarily helpful if there is excess fat under the chin or along the jawline contributing to the sagging appearance.

Alone, it won’t reposition the soft tissue or correct asymmetry in muscle or bone.

Dermal fillers:

Can add projection and volume to improve balance with the rest of your face.

Can also help with minor asymmetry and create a more harmonious profile.

Results are semi-permanent, lasting about 1–2 years depending on the filler.

Surgical options:

Genioplasty (chin surgery): Can reposition or reshape the bone for a permanent improvement in projection and symmetry.

Submental lift or neck/chin lift: Can address sagging tissue if ptosis is more pronounced.

These are more invasive but provide lasting results.

Given your age (22) and your goal for more permanent results, non-surgical options like Botox or fillers may help temporarily, but structural or surgical interventions will have the most lasting impact if bone alignment or soft tissue sagging is the main issue.

From what I see in your photos, a combination approach is often most effective: addressing asymmetry with fillers or surgical reshaping, and smoothing soft tissue with Botox or minor liposuction if needed.

It’s completely normal to explore options before a consultation—you’re thinking carefully about longevity and results, which is smart.

Should I do chin liposuction, Botox, or something else to help with my chin ptosis? (Photos)

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